DENTAL SPECIALTY OF
Before major advances in the treatment of diseases
of the dental pulp and periapical tissues were made,
dentists extracted many teeth needlessly. Endodontics
is the dental specialty primarily concerned with these
diseases. In some dental clinics, an endodontist is
assigned exclusively to this specialty. Often, some of
the restorative dentists spend part of their time seeing
patients who require endodontic treatment, also known
as root canal therapy. As a basic dental assistant, you
must be familiar with the following aspects of
Functions, causes, and diagnosis
Types of procedures
Steps in pulpectomy and root canal treatment
Steps in apicoectomy and associated procedures
You must also be able to identify:
When involved with endodontic procedures, you
must follow BUMEDINST 6600.10, Dental Infection
Control Program. Strict compliance to sterile
technique, sterilization, and disinfection is absolutely
essential in endodontic treatment.
The primary purpose of endodontics is the
treatment of diseases of the pulp and periapical tissues.
The goal of this treatment is to retain the natural teeth
rather than extract them. Often, the endodontic
patients initial appointment is of an urgent nature
because of the associated pain or infection.
Understanding the causes of pulp disease and how a
diagnosis is reached will increase your ability to be an
effective endodontic assistant.
The dental pulp can be injured in several ways.
Some injured teeth can be treated and returned to
normal. Other injured pulpal tissue may undergo
necrosis (die) after the slightest injury. Some of the
most common causes of injury to the pulp include
dental caries (covered in Dental Technician, Volume 1,
NAVEDTRA 12572, chapter 5, "Oral Pathology"),
traumatic blows to the teeth, pulp exposure (covered in
Dental Technician, Volume 1, NAVEDTRA 12572,
chapter 6, "Emergency Treatment of Oral Diseases and
Injuries"), chemical irritation, and thermal irritation.
Traumatic blows to the teeth can result from
situations such as common household accidents, auto
collisions, or athletic injuries. A sharp blow to one or
more teeth can result in fracture of the crown or root, or
even the avulsion (forcefully knocked out of the
socket) of the complete tooth, cutting off the blood
flow to the pulp.
Chemical irritation after placement of certain
chemical substances commonly used in restorative
procedures can cause pulp injury or death. Another
cause of chemical irritation is a faulty restoration,
which allows oral fluids to leak between the restoration
Thermal irritation can cause pulp injury and
patients will experience discomfort when they inhale
cold air through their mouths. If metallic restorative
materials are placed close to the pulp, the patient w-ill
experience thermal irritation.
The diagnosis of pulp and periapical conditions
must precede the treatment. Endodontic diagnosis is a
result of the skillful use and interpretation of several
methods. Some of the more common methods are
discussed in the paragraphs that follow.